Find out how the Affordable Care Act (ACA) affects your group size.

Call our Small Business Services Customer Connection Team at 800-790-4661, option 3 at least 90 days before your group's anniversary date to avoid delays.

1. I completed the Electronic Transfer for Initial Payment form to set up automatic payments. Why aren’t payments being automatically deducted from my bank each month?

The Electronic Transfer for Initial Payment form only authorizes us to withdraw the first month’s premium from a bank account. To set up automatic payments from the second month onward, your group’s administrator still needs to complete an Online Account Services User ID Request Form and submit it by 1 of the 3 following ways:

• By mail: 3840 Murphy Canyon Rd. San Diego, CA 92123
• Email: CSC-SD-SBA@kp.org.
• Fax: 858-614-3345

Then your group administrator will be able to set up auto payments through online account services.

2. How can I see my bills online?

You can view and pay your bills online through online account services.

3. How many past statements can my clients see online?

You can now see 2 years’ worth of statements in PDF file format through online account services.

4. I recently made a change to my account. How come the changes aren’t reflected in my statement?

It can take up to 2 billing cycles for changes to appear on statements.

If you have already received the bill for the month your changes went into effect, don’t worry — just pay it as is. Adjustments for your changes and what you’ve already paid will appear in the “Retroactive Dues and Charges” section on your next statement. You may also view your change online through online account services.

If you have any other questions not covered here, please contact the California Service Center, option 1.

To make sure your request is processed efficiently, follow these guidelines when you email a request to our Small Business Services California Service Center¹.

1.Include a clear subject line

The subject line should include your:

• Company name
• Purchaser identification (PID) number
• Request

Subject line example:

ABC company-123456-subscriber termination request

2.Use recommended attachment formats

Use these file formats for attachments: .doc, .docx, .xls, .xlsx, .pdf, .bmp, .txt, .tif, .tiff, .jpg, .jpeg.

Don’t use: .gif, .mpg, .rar, .avi, .wmv.

3.Don’t include important information in body of email

Only the attachments included in your emails will be processed. Any requests made in the body of an email won’t be addressed.

4.Email the right team

Remember to submit enrollment applications, account change forms, and member terminations² to our California Service Center.

For other types of requests, go to our contact us page or download our small business service reference guide.

¹ The California Service Center’s e-mail box is unmonitored. It cannot reply to questions and can only accept forms. If you would like to include specific instructions or notes with the application, be sure to include them as an attachment and not in the body of the e-mail.

² Terminations must be received in the month of the subscriber or group termination.

Your broker of record (BOR) is the broker authorized to represent your decisions on health plan coverage. Your BOR may receive copies of the communications we send to you, including quotes, notifications, and policy information.

From time to time, you may wish to add, change, or remove a BOR. Here are some common questions you might have while navigating that process.

1. Who is authorized to make a broker of record (BOR) change?

A BOR change request can be made only through a letter signed by the contract signer or an interested party authorized to make contract changes at your company.
Note: When adding an Interested Party using the Contact Change form, be sure you check the box that authorizes the interested party to make changes on behalf of your company. Otherwise, the interested party will not have authority to make any changes,such as adding a broker of record (BOR).

• The contract signer is the person responsible for signing the group agreement. He or she is the main person authorized to make membership or contract changes to your account.
• An interested party can be any person authorized to access information about the group, such as enrollees, premium contributions, and plan selections. An interested party may also be authorized to make contract changes to the contract, such as adding or deleting employees, adding or deleting plans, increasing or decreasing premium contributions.

Important: If the BOR change request letter hasn’t been signed by the contract signer or an interested party authorized to make changes to the contract, we’ll return it to you for correction. This will delay the process until a new request letter with an authorized signature is received.

2. How do we add, change, or remove a BOR?

To add, change, or remove a BOR, you must submit a BOR change request on your company’s letterhead. Here are some important things you’ll need to include:

• Your current broker’s identification number and name as the agent of record
• The effective date of the BOR change. Future-dated requests are acceptable, but we can’t honor backdated requests. Requests dated after the first of the month will have an effective date for the following month at the earliest.
• The signature of the contract signer or interested party, as well as his or her printed name and title

When your letter is complete and signed, send it to the Small Business Service Customer Connection Team — preferably by email to amt@kp.org. You can also fax it to 800-369-8010.

3. How long does it take to process a BOR change?

It typically takes between 48 and 72 hours to process change requests.

4. It’s been more than 72 hours. Why hasn’t our BOR change request been processed yet?

If a request isn’t in the system after three days or more, it’s typically because some of the required materials weren’t received or because the request was backdated. Ask your new BOR whether you should resubmit the request.

5. When is the BOR change effective?

The effective date for your BOR change depends on the date we receive your request. Paperwork must be received by the fifth business day of a month for the change to be effective on the first of that month. A BOR request letter dated after the first of the month will be effective the following month.

For example, if a change request was properly submitted and received on December 3, 2016, it should have an effective date of December 1, 2016. However, if a change request was submitted December 3, 2016, but it was incomplete and updated information wasn’t received until December 10, 2016, then the change would have an effective date of January 1, 2016.

6. Why is my previous broker still appearing on correspondence?

This could be a timing issue — for example, if we hadn’t yet processed your BOR change request at the time of a renewal. It could also be because:

• We didn’t receive your BOR request.
• It was incomplete or wasn’t signed by the contract signer or an interested party.
• It hasn’t been forwarded to the proper department yet.

Important: You should always keep proof of delivery, either email or fax confirmation, to show the date Kaiser Permanente received the request letter since this can affect the effective date.

7. How will my previous BOR find out about the change?

It’s your responsibility to inform your previous broker if he or she is being replaced. We’ll send out a courtesy letter when we process a BOR request, but if there are delays in processing the request, that notice will also be delayed.

8. My previous BOR says he wasn’t officially notified of the change. How did that happen?

We typically send a notification letter on the day any BOR change is processed. For future-dated small business BOR changes, we typically send the letter within a week of the processing date. If your previous broker didn’t receive a letter, please have him or her contact their account manager.

Please note that we cannot always accommodate requested effective dates. If your group has paid its premiums in advance and your broker has already received commission, the effective date will be the first day of the coverage period that hasn’t yet generated a commission payment for your group.

9. When does a BOR change show up online?

Once a change has been processed, it should show up online right away. If the BOR change was completed for a future effective date, the change shouldn’t show up online until that date.

If you have any other questions not covered here, please call our Small Business Services Customer Connection Team at 800-790-4661,
option 3.

Under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), employees and their families can continue to get group health coverage for a period of time after the employee no longer works for the company. Your employees and their families may qualify for COBRA coverage in these situations:

• Voluntary or involuntary job loss
• Reduction in hours worked
• Divorce from the covered employee
• Death of the covered employee

For more information on COBRA, please see the “COBRA regulations” section of the “Government guidelines” page.

1. How do I know who’s enrolled in COBRA?

Only small businesses with active COBRA members, will receive a Billed Federal COBRA Activity Report from Kaiser Permanente listing current COBRA members for that month.

The report also lists former employees who:

• have missed COBRA payments
• are being terminated from COBRA, either for nonpayment, or because they’ve reached the maximum period of COBRA continuation coverage

2. Who receives the COBRA activity report?

The person at your company who’s been specified as the contract signer will automatically receive the report.

3. What if I want someone other than the contract signer to receive the report?

To have the activity report sent to someone else at your company, please contact our Small Business Services Customer Connection Team at 1-800-790-4661, option 3.

4. Who can answer questions about the COBRA activity report?
Contact our California Service Center at 1-800-790-4661, option 1.

1. When you make health plan changes at renewal, double-check your paperwork.

• You must complete, sign, and fax all pages of the Renewal Changes form to 800-369-8010 or send by email to amt@kp.org. If you make changes to Section 1 and/or Section 2, you must include Section 9 (Census).
• You must verify health plan changes or additions for each current and new employee by reviewing all their paperwork. Section 9 of the Renewal Changes form.
• If you aren’t making any changes, there’s no need to submit the Renewal Changes form.

2. Submit changes before your renewal date.

• To ensure all updates are in place for you and your employees by your effective date, make sure changes are submitted by the 1st of your renewal effective month.
• Health plan changes received by 5 p.m. Pacific time (PT) on the 15th of the month will be applied retroactively to the 1st of their renewal month. Changes received after 5 p.m. PT on the 15th of the month will be effective the 1st of the following month.

You’ll receive a health plan change acknowledgment letter when the request is approved.

Please note: If you leave a grandfathered (nonmetal) health plan, you won’t be able to go back to it.

Avoid processing delays by making sure that you understand your multiple plan options and how to submit your paperwork.

1. Remember the basic rules of offering multiple plans

Depending on how many subscribers you have, you may offer a different number of Kaiser Permanente plans to your employees:

• If you have fewer than five enrolled subscribers, you can offer a choice of up to three Kaiser Permanente plans.
• If you have six or more enrolled subscribers, you can offer as many Kaiser Permanente plans as you like.

If you have fewer than five subscribers and select four or more plans, you’ll get a letter asking you to add another subscriber or reduce the number of plan selections — which will cause processing delays.

2. Make sure you complete and submit the right paperwork

There are two ways for you to submit plan changes:

1) Changes can be made during your annual renewal using the Renewal Changes form located in your renewal package, or

2) you can make midyear plan changes using the Plan/Add Change Request form available online.

Either way, the most important information is the plan(s) you want to add or cancel — which is covered in section 2 of the Renewal Changes form and section 3 of the Plan/Add Change Request form, respectively.

You also need to confirm that you list any plan changes or additions for every current and new employee. This is covered in section 9 of the Renewal Changes form and section 4 of the Plan Add/Change Request form. Please check that the plan names listed in these sections are currently available.

Finally, remember to fully complete, sign, and fax back the materials.

3. Submit all your plan changes at the same time

When you make plan changes, submit all fully completed forms at once. Any missing information or subsequent changes will result in processing delays.

If you have locations in Northern and Southern California, and the non-headquarters region has at least 13 Kaiser Permanente subscribers, you may need to separate your contract. This will give each location its own contract and customer identification number (CID).

• Your group only needs to separate contracts at your renewal — not midyear.
• If you offer Kaiser Permanente Insurance Company (KPIC) plans (PPO), you need to submit a New Group Application. A Small Business Customer Service Connection Team representative will reach out to help you with the process.
• If your group doesn’t offer a PPO plan, you don’t need to do anything. Kaiser Permanente will separate and renew the group for you. Any members affected by the separation will get a new ID card.

What if my group uses Electronic Data Interchange (EDI) to send files?

After separating your group, you must update your EDI file with the employees from each region. We recommend making updates by the end of your renewal month.

What if my group uses online account services?

The group with the original contract will need to add the new location on online account services by filling out our Online Account Services User ID Request Form. Be sure to include the CID of the group with the original contract and the new CID of the other region. After making the updates, you’ll be able to access both regions from one account.  

How many bills will I get?

You may receive a bill for each contract. Billing may take 1 to 2 months to catch up after the separation. Until that happens, you may see a credit or retro charges on your bills. We recommend you pay as billed.

If I offer one or more grandfathered plans, will the risk adjustment factor stay the same after the separation?

Yes, the grandfathered risk adjustment factor stays the same for both groups if you offer one or more grandfathered plans.

Do my employees’ deductible and out-of-pocket accumulations follow them if they’re moving to the new location?

Yes. After the member is transferred, we’ll transfer all deductible and out-of-pocket accumulations. This process can take 30 days or more to complete after the group’s renewal date.

Why are my employees receiving a Certificate of Creditable Coverage letter?

We are required to send this letter when any member is terminated from a group. Affected members who are terminated from the contract for the headquartered location will receive a Certificate of Creditable Coverage letter. Members affected by the separation can disregard the letter because they were immediately enrolled in the new group located in the opposite region.

How long does it take to separate a group?

It takes about 4 weeks, not including the time it takes to transfer any deductible or out-of-pocket accumulations.

What if I have more questions?

Please contact our Small Business Services Customer Connection Team at 800-790-4661, option 3.

How do I terminate my contract with Kaiser Permanente?

1. Call our Small Business Customer Connection Team at 800-790-4661, option 3, Monday through Friday, 8:30 a.m. to 5 p.m. Pacific time.

2. Ask for a Group Termination Request form. The Customer Connection Team will help you complete the form over the phone, then email it to you so your authorized contract signer can sign it with a wet signature. Termination requests on your company’s letterhead aren’t accepted.

3. Please email the signed Group Termination Request form to amt@kp.org or fax it to 800-369-8010.

Who’s responsible for stopping autopay?

If your group pays its premium through autopay, it’s your responsibility to stop autopay once all premium owed has been paid. If you have questions on how to stop autopay, please call our California Service Center at 800-790-4661, option 1.

Can I request reinstatement of my contract later?

Yes, you can request reinstatement of your contract within 60 days of your termination date without lapse in coverage and without needing to go back through the underwriting process.

Can I use a Declination of Coverage form to request termination of my contract?

No. The Declination of Coverage form is for employees who want to decline group health coverage with Kaiser Permanente.

Your employees will get new ID cards when they:

• Become new Kaiser Permanente members
• Switch to a plan that uses another type of card (for example, from small business coverage to Medicare coverage)
• Have a gap in coverage that’s 396 days or more
• Lose their card and ask for a replacement through Member Services*

Understanding when we don’t send new member ID cards

Your employees won’t get new ID cards when they:

• Switch to a plan that uses the same type of card (for example, from an HMO plan to a deductible HMO plan)
• Have a gap in coverage that’s 395 days or less
• Renew their Kaiser Permanente plan every year

_{^* Most members can also access their digital ID card through kp.org or the Kaiser Permanente app. This option is not available for Northern California, Medicare members, and some out-of-area plans.}

Find our latest health coverage information. For news, visit the Kaiser Permanente News Center.